Purpose

This bill changes how fines are assessed and used for home care licensing surveys and investigations, updates who serves on the Home Care and Assisted Living Advisory Council, and creates a grant program funded by these fines to support home care providers and improve client quality of care and outcomes—especially in areas like workforce and clinical results.

Main provisions and what the bill seeks to accomplish

• Fines and enforcement for home care licensing surveys and investigations

  • Establishes a tiered fine system based on the level and scope of violations, with immediate fines allowed. Levels:
  • Level 1: no fines or enforcement
  • Level 2: $500 per violation
  • Level 3: $1,000 per incident
  • Level 4: $3,000 per incident
  • Level 5: $5,000 per violation
  • Special consideration for maltreatment: violations where maltreatment (per Minnesota law on maltreatment) is found can carry a baseline $1,000 fine, with up to $5,000 for maltreatment cases involving sexual assault, death, or serious injury.
  • Immediate fines are allowed for both surveys and investigations; however, if a maltreatment finding exists, the agency cannot impose a second immediate fine for the same incident.
  • Correction orders are categorized by level and scope, with fines tied to those categories. Scope can be isolated, pattern, or widespread.
  • For every identified violation, an immediate fine can be issued in addition to other enforcement tools. Violations must be corrected within a specified time, and the immediate fine can be appealed.
  • License holders must pay fines by the due date; failing to pay can trigger a second fine or license suspension. A timely appeal stays payment until a final order is issued.
  • If a violation is found not corrected after a reinspection, a second fine may be issued. Notices are sent to the license holder’s last known address.
  • A license holder cannot avoid fines by closing or transferring the licensed program to a third party; the original license holder remains liable.
  • The state may charge a separate penalty to cover investigation costs.
  • Fines collected are deposited into a dedicated special revenue account and are annually appropriated to implement recommendations of the advisory council.

• Use of fines for improvement and grants

  • Funds from the dedicated account are used to support a competitive grant program for special projects aimed at improving home care client quality of care and outcomes, with a focus on workforce and clinical outcomes.
  • Grants must align with criteria in the related statute and be distributed to licensed home care providers or knowledgeable organizations in home care operations and practices.
  • Each grant must be at least $1,000; providers with temporary licenses are not eligible.
  • The department may retain up to 10% of funds to cover grant administration costs.
  • The department must publish an annual report detailing fines collected and how the funds were allocated.

• Advisory Council changes and composition

  • Creates a 14-member Home Care and Assisted Living Advisory Council appointed by the Commissioner of Health, with specific seats:
  • Four public members (including at least: a person who has received home care, a family member of someone who has, a resident of an assisted living facility, and a family member of someone in assisted living)
  • Two Minnesota home care licensees (representing basic and comprehensive licensure)
  • One Board of Nursing member
  • One representative from the Office of the Ombudsman for Long-Term Care
  • One representative from the Office of the Ombudsman for Mental Health and Developmental Disabilities
  • One county health and human services or county adult protection office representative
  • Two Minnesota assisted living facility licensees
  • One organization representing long-term care providers, home care providers, and assisted living providers
  • One consumer advocacy organization representative
  • Vacancy timelines require timely appointment of qualified applicants; specific guidance is provided for when qualified applicants are or are not available.

• Special Projects Grant Program timeline and specifics

  • By December 31, 2028, distribute the remaining balance in the special revenue account (as of January 1, 2027) through a competitive grant program for special projects to improve home care client quality of care and outcomes, with a focus on workforce and clinical outcomes.
  • Grants go to licensed home care providers or organizations with relevant experience; minimum grant amount is $1,000.
  • Temporary license holders are not eligible.
  • Any funds not awarded as grants by December 31, 2028, must be used for annual distributions under the related statute beginning January 1, 2029.

Key changes to existing law

• Creates a structured, tiered fines framework with immediate enforcement for home care licensing violations, including maltreatment scenarios, and links fines to correction timelines and appeal rights.
• Establishes a dedicated special revenue fund for fines and directs annual appropriations to a grant program aimed at improving home care workforce and clinical outcomes.
• Reorganizes and expands the Home Care and Assisted Living Advisory Council, detailing specific public, provider, consumer, and regulatory representation.
• Institutes a time-bound, grant-based approach to invest in special projects that improve home care services, with minimum grant sizes and administration safeguards.

Significant changes at a glance

• Immediate, tiered fines for home care violations, including maltreatment-related penalties
• Clear correction order processes with timelines, notices, and appeal rights
• Funds from fines dedicated to a grant program focused on workforce and clinical outcomes
• New and expanded advisory council composition with explicit stakeholder representation
• Deadline-driven grant distribution plan, with a sunset-like requirement for using remaining funds by 2028 and ongoing distributions thereafter

Potential impacts

• Increased accountability for home care providers and licensees through a formal fines schedule and expeditious enforcement
• More funds directed toward improving home care staffing, operations, and client outcomes via grants
• Greater stakeholder input in policy through a codified advisory council with diverse representation
• Greater transparency through annual reporting on fines and fund allocations

Relevant Terms fines; enforcement actions; immediate fine; correction order; maltreatment; sexual assault; serious injury; death; Level 2/3/4/5 violations; isolated/pattern/widespread scope; license suspension; appeal; reconsideration; transfer liability; investigation costs; dedicated special revenue account; grants; competitive grant program; minimum grant; administration costs; advisory council; home care; assisted living; licensure; 144A.474; 144A.4799; workforce outcomes; clinical outcomes; patient quality of care; long-term care; Office of Ombudsman; Board of Nursing; public members; consumer advocacy; grant reporting; grant distribution deadlines.